COVID-19 and multisystem inflammatory syndrome in children and adolescents

Lancet Infect Dis. 2020 Nov;20(11):e276-e288. doi: 10.1016/S1473-3099(20)30651-4. Epub 2020 Aug 17.

Abstract

As severe acute respiratory syndrome coronavirus 2 continues to spread worldwide, there have been increasing reports from Europe, North America, Asia, and Latin America describing children and adolescents with COVID-19-associated multisystem inflammatory conditions. However, the association between multisystem inflammatory syndrome in children and COVID-19 is still unknown. We review the epidemiology, causes, clinical features, and current treatment protocols for multisystem inflammatory syndrome in children and adolescents associated with COVID-19. We also discuss the possible underlying pathophysiological mechanisms for COVID-19-induced inflammatory processes, which can lead to organ damage in paediatric patients who are severely ill. These insights provide evidence for the need to develop a clear case definition and treatment protocol for this new condition and also shed light on future therapeutic interventions and the potential for vaccine development. TRANSLATIONS: For the French, Chinese, Arabic, Spanish and Russian translations of the abstract see Supplementary Materials section.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus*
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Infant
  • Infant, Newborn
  • Male
  • Mucocutaneous Lymph Node Syndrome / drug therapy
  • Mucocutaneous Lymph Node Syndrome / immunology
  • Pandemics
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / virology
  • Risk Factors
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Systemic Inflammatory Response Syndrome / epidemiology*
  • Systemic Inflammatory Response Syndrome / immunology*
  • Systemic Inflammatory Response Syndrome / virology
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antiviral Agents
  • Immunoglobulins, Intravenous

Supplementary concepts

  • COVID-19 drug treatment
  • pediatric multisystem inflammatory disease, COVID-19 related